Wei Kai-Che, Lai Ping-Chin
Department of Dermatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
Dermatol Ther. 2015 Jan-Feb;28(1):25-7. doi: 10.1111/dth.12176. Epub 2014 Oct 6.
Severe forms of psoriasis that are refractory to conventional therapies are often difficult to manage. The mammalian target of rapamycin (mTOR) inhibitors potentially have versatile effects toward putative psoriatic pathologic pathways. Therefore, mTOR inhibitors may offer a range of new therapeutic options for patients with psoriasis. We describe a 55-year-old male renal transplant patient with refractory psoriasis. We adjusted his antirejection regimen and put him on everolimus (Certican(®); Novartis, Basel, Switzerland; a semisynthetic macrolide, belonging to the mTOR inhibitors family) with low-dose tacrolimus. This combination regimen maintained his graft function and successfully controlled his psoriasis. His skin lesions never recurred in the next 18 months. To our knowledge, this is the first report showing that the combination of everolimus and tacrolimus could be used to treat recalcitrant psoriasis. The relative benefit-risk profiles of such therapies worth further investigation.
对传统疗法难治的重度银屑病往往难以处理。雷帕霉素靶蛋白（mTOR）抑制剂可能对假定的银屑病病理途径具有多种作用。因此，mTOR抑制剂可能为银屑病患者提供一系列新的治疗选择。我们描述了一名55岁难治性银屑病男性肾移植患者。我们调整了他的抗排斥方案，并让他服用依维莫司（Certican®；瑞士巴塞尔诺华公司；一种半合成大环内酯类药物，属于mTOR抑制剂家族）及低剂量他克莫司。这种联合方案维持了他的移植肾功能，并成功控制了他的银屑病。在接下来的18个月里，他的皮肤病变从未复发。据我们所知，这是首次报告显示依维莫司和他克莫司联合可用于治疗顽固性银屑病。此类疗法相对的获益风险情况值得进一步研究。
